Establishing the Administrative Structure and Support for a Healthcare Transition Program

  • Mary R. Ciccarelli
  • Jason Woodward


The goal of this chapter is to demonstrate key steps in the establishment of administrative structure and support to successfully develop a healthcare transition program across the variety of possible models. The intent is not to create a one-size-fits-all program but rather to consider the methodology of program development in a systematic way. The chapter will discuss a systematic approach to the development and support of a transition program utilizing an implementation science and logic model framework. Specific components of the six stages of implementation science (exploration and adoption, installation, initial implementation, full operation, innovation, and sustainability) are described as they relate to establishing structure and support for a transition program. Key inputs, resources, activities, output, outcomes, or impact/aims to consider at each stage of implementation are presented. Several examples of logic models are provided to explain application of the logic model framework in development of an administrative structure and support for a transition program.


Logic model framework Implementation science Healthcare transition program 


  1. 1.
    W.K. Kellogg Foundation Evaluation Handbook. In: W.K. Kellogg Foundation. 2010. Accessed 22 Oct 2017.
  2. 2.
    Fixsen DL, Naoom SF, Blasse KA, Friedman RM, Wallace F. Implementation research: a synthesis of the literature. Tampa, FL: University of South Florida, Louis de la Parte Mental Health Institute, The National Implementation Research Network (FMHI Publication #231); 2005.Google Scholar
  3. 3.
    Adelman HS, Taylor L. On sustainability of project innovations as systemic change. J Educ Psychol Consult. 2003;14:1–25.CrossRefGoogle Scholar
  4. 4.
    Chase G. Implementing a human service program: how hard will it be? Public Policy. 1979;27:385–434.PubMedGoogle Scholar
  5. 5.
    Rosenheck RA. Organizational process: a missing link between research and practice. Psychiatr Serv. 2001;52:1607–12.CrossRefGoogle Scholar
  6. 6.
    Reiss JG, Gibson RW, Walker LR. Health care transition: youth, family, and provider perspectives. Pediatrics. 2005;115:112–20.CrossRefGoogle Scholar
  7. 7.
    Andrade DM, Bassett AS, Bercovici E, et al. Epilepsy: transition from pediatric to adult care. Recommendations of the Ontario epilepsy implementation task force. Epilepsia. 2017;58:1502–17.CrossRefGoogle Scholar
  8. 8.
    Renault V Section 14. SWOT analysis: strengths, weaknesses, opportunities, and threats. In: Chapter 3. Assessing community needs and resources|Main Section|Community Tool Box. Accessed 22 Oct 2017.
  9. 9.
    Dogba MJ, Rauch F, Wong T, Ruck J, Glorieux FH, Bedos C. From pediatric to adult care: strategic evaluation of a transition program for patients with osteogenesis imperfecta. BMC Health Serv Res. 2014;14:489.CrossRefGoogle Scholar
  10. 10.
    Edwards RW, Jumper-Thurman P, Plested BA, Oetting ER, Swanson L. Community readiness: research to practice. J Community Psychol. 2000;2:291–307.CrossRefGoogle Scholar
  11. 11.
    Kostadinov I, Daniel M, Stanley L, Gancia A, Cargo M. A systematic review of community readiness tool applications: implications for reporting. Int J Environ Res Public Health. 2015;12:3453–68.CrossRefGoogle Scholar
  12. 12.
    American Academy of Pediatrics; American Academy of Family Physicians American College of Physicians; Transitions Clinical Report Authoring Group, Cooley WC, Sagerman PJ. Supporting the health care transition from adolescence to adulthood in the medical home. Pediatrics. 2011;128:182–200.CrossRefGoogle Scholar
  13. 13.
    Pediatric to Adult Care Transitions Initiative. In: Pediatric to Adult Care Transitions Initiative|Resources for Clinicians|ACP. Accessed 24 Oct 2017.
  14. 14.
    Got Transition/Center for Health Care Transition Improvement. Six Core Elements of Health Care Transition 2.0. In., a program of the National Alliance to Advance Adolescent Health. 2014. Accessed 22 Oct 2017.
  15. 15.
    Binks JA, Barden WS, Burke TA, Young NL. What do we really know about the transition to adult-centered health care? A focus on cerebral palsy and spina bifida. Arch Phys Med Rehabil. 2011;88:1064–73.CrossRefGoogle Scholar
  16. 16.
    Hepburn CM, Cohen E, Bhawra J, Weiser N, Hayeems RZ, Guttmann A. Health system strategies supporting transition to adult care. Arch Dis Child. 2015;100:559–64.CrossRefGoogle Scholar
  17. 17.
    Funding Guide|Identifying and Accessing Funding Opportunities. In: County Health Rankings & Roadmaps. University of Wisconsin Population Health Institute. Accessed 22 Oct 2017.
  18. 18.
    McManus M, Beck D. Transition to Adult Health Care and State Title V Program Directions: A Review of 2017 Block Grant Applications. Report 3 Got Transition/Center for Health Care Transition Improvement, The National Alliance to Advance Adolescent Health. 2017.
  19. 19.
    Tuchman LK, Schwartz LA, Sawicki GS, Britto MT. Cystic fibrosis and transition to adult medical care. Pediatrics. 2010;125:566–73.CrossRefGoogle Scholar
  20. 20.
    Field MJ, Jette AM, editors, Institute of Medicine (US) Committee on Disability in America (2007) The future of disability in America. National Academies Press, Washington, DC.Google Scholar
  21. 21.
    Crowley R, Wolfe I, Lock K, McKee M. Improving the transition between paediatric and adult healthcare: a systematic review. Arch Dis Child. 2011;96:548–53.CrossRefGoogle Scholar
  22. 22.
    Van Walleghem N, Macdonald CA, Dean HJ. Evaluation of a systems navigator model for transition from pediatric to adult care for young adults with type 1 diabetes. Diabetes Care. 2008;31:1529–30.CrossRefGoogle Scholar
  23. 23.
    Weitzman ER, Kaci L, Quinn M, Mandl KD. Helping high-risk youth move through high-risk periods: personally controlled health records for improving social and health care transitions. J Diabetes Sci Technol. 2011;5:47–54.CrossRefGoogle Scholar
  24. 24.
    Rabinowitz P Section 1. Developing a plan for staff hiring and training. In: Chapter 10. Hiring and training key staff of community organizations | Main Section | Community Tool Box. Accessed 22 Oct 2017.
  25. 25.
    Shanske S, Arnold J, Carvalho M, Rein J. Social workers as transition brokers: facilitating the transition from pediatric to adult medical care. Soc Work Health Care. 2012;51:279–95.CrossRefGoogle Scholar
  26. 26.
    Betz CL. Facilitating the transition of adolescents with developmental disabilities: nursing practice issues and care. J Pediatr Nurs. 2007;22:103–11.CrossRefGoogle Scholar
  27. 27.
    van Staa A, Sattoe JN, Strating MM. Experiences with and outcomes of two interventions to maximize engagement of chronically ill adolescents during hospital consultations: a mixed methods study. J Pediatr Nurs. 2015;30:757–75.CrossRefGoogle Scholar
  28. 28.
    Ciccarelli MR, Brown MW, Gladstone EB, Woodward JF, Swigonski NL. Implementation and sustainability of statewide transition support services for youth with intellectual and physical disabilities. J Pediatr Rehabil Med. 2014;7:93–104.PubMedGoogle Scholar
  29. 29.
    Vyt A. Interprofessional and transdisciplinary teamwork in health care. Diabetes Metab Res Rev. 2008;24:S106–9.CrossRefGoogle Scholar
  30. 30.
    Embrett MG, Randall GE, Longo CJ, Nguyen T, Mulvale G. Effectiveness of health system services and programs for youth to adult transitions in mental health care: a systematic review of academic literature. Adm Policy Ment Health. 2016;43:259–69.CrossRefGoogle Scholar
  31. 31.
    Gee PM, Greenwood DA, Paterniti DA, Ward D, Miller LM. The eHealth enhanced chronic care model: a theory derivation approach. J Med Internet Res. 2015;17:e86.CrossRefGoogle Scholar
  32. 32.
    de Jong CC, Ros WJ, Leeuwen MV, Schrijvers G. How professionals share an E-care plan for the elderly in primary care: evaluating the use of an E-communication tool by different combinations of professionals. J Med Internet Res. 2016;18:e204.CrossRefGoogle Scholar
  33. 33.
    McAnaney DF, Wynne RF. Linking user and staff perspectives in the evaluation of innovative transition projects for youth with disabilities. J Intellect Disabil. 2016;20:165–82.CrossRefGoogle Scholar
  34. 34.
    How to change your Organization’s culture. In: The wall street journal guide to management: building a workplace culture, adapted from The WSJ Complete Small Business Guidebook. New York:Three Rivers Press, 2009. Accessed 22 Oct 2017.
  35. 35.
    Hergenroeder AC, Wiemann CM, Bowman VF. Lessons learned in building a hospital-wide transition program from pediatric to adult-based health care for youth with special health care needs (YSHCN). Int J Adolesc Med Health. 2016;28:455–8.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Indiana University School of MedicineIndianapolisUSA
  2. 2.Cincinnati Children’s Hospital Medical CenterCincinnatiUSA

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